AUGUSTA — Gov. Paul LePage announced Wednesday that he will gather top law enforcement officials and drug treatment advocates at a summit this month to address the state’s drug epidemic.
The announcement follows a report in the Portland Press Herald on 14 heroin overdoses that occurred in Portland during the 24-hour period beginning at 8 a.m. Friday. The overdoses are a potential watershed moment in a state grappling with a dramatic increase in heroin use. In July, mayors from Portland and other Maine cities met with Department of Health and Human Services Commissioner Mary Mayhew to discuss the heroin problem and its effects on law enforcement, treatment providers and individuals pulled into the drug’s destructive, often lethal, grip.
Read LePage's letter about the drug epidemic
The meeting and the governor’s call for a summit are likely to rekindle a simmering debate about the appropriate balance between funding treatment programs and funding law enforcement efforts to combat trafficking.
LePage has been campaigning since last year to beef up drug enforcement, and in a letter Wednesday to legislative leaders, he urged lawmakers to reconsider his request to increase funding for agents for the Maine Drug Enforcement Agency.
“The national and state media is finally paying attention to Maine’s drug crisis, and we are hearing stories on a daily basis about overdoses from heroin and other opiates,” LePage wrote in his letter. “You must take action now to stop the flow of this deadly poison into our state.”
Democratic House Speaker Mark Eves of North Berwick responded quickly to the Republican governor’s call for more law enforcement, saying Mainers have lost access to health care as a result of MaineCare cuts under his administration, and that treatment centers are closing because of a lack of funding or low reimbursement levels.
“The obituaries and news stories we’ve seen in recent weeks show the drug crisis in our state is a health care crisis, not just a matter of law enforcement,” Eves said. “The longer the governor keeps the blinders on, the more Maine families will suffer.”
The exchange between Le- Page and Eves illustrates the conflict that lies ahead. Although the July 6 meeting between DHHS Commissioner Mayhew and several mayors didn’t produce any initiatives, Portland Mayor Michael Brennan said the mayors hope to meet with Mayhew again in September and submit a proposal that may include ideas that Mayhew and the LePage administration oppose.
“I’ve got to believe that Maine- Care, or reimbursement rates, or access to insurance will come up,” Brennan said.
MAYHEW DEFENDS DHHS SPENDING
DHHS has said that treatment funding is adequate and that spending increased from $75 million in 201213 to $77 million in 2014-15. The agency said Tuesday that the state spent $16.4 million last year on treatment programs available to Mainers regardless of whether they had insurance coverage, and that programs have the capacity to deal with a sharp spike in heroin users seeking treatment.
“The growing heroin epidemic in Maine is a serious problem that will not simply be fixed by increased spending at DHHS,” Mayhew said in a statement Tuesday. “The problem is not that the $16.4 million DHHS spends annually on addiction treatment for the uninsured is too low, but that many addicts who begin treatment never even complete it.”
David Sorensen, a spokesman for DHHS, said some grant funding for treatment services was not being spent and was returned to the state’s General Fund. He did not provide specific figures, but said that only 36 percent of people who enter state-funded treatment programs complete them. In some locations, he said, the completion rate is as low as 15 percent.
Decreasing MaineCare spending has been a key goal for the LePage administration, which has argued that the state is too generous with its support programs. The administration has gone to court – and lost – battles to reduce MaineCare eligibility, but it’s also managed to reduce caseloads by scaling back eligibility for some Mainers. It’s also defeated several attempts in the Legislature to expand MaineCare through an initiative in the Affordable Care Act that would have provided health coverage to an estimated 70,000 residents.
MAINECARE ENROLLMENT DECLINES
Advocates for treatment have argued that the administration’s position could mean the state is unable to keep pace with increased heroin use. DHHS figures from May show that Maine- Care enrollment has declined from 355,000 patients in 2011 to 287,000. Substance abuse providers say this decline has hurt access for low-income, uninsured patients who may need treatment. Most outpatient programs do not accept uninsured patients.
Sorensen said “the treatment needs of those who have lost (MaineCare) coverage are being met.” He said of all Mainers seeking addiction treatment, the share covered by Medicaid has dropped from 29 percent to 22 percent from 2014 to 2015. The share of those receiving treatment from programs funded by the Office Substance Abuse and Mental Health Services has increased from 40 percent to 48 percent.
The number of heroin users seeking treatment has tripled from 1,115 in 2010 to 3,463 in 2014, according to state data.
“This issue is a major one throughout the state,” Bangor Mayor Nelson Durgin said Tuesday. He said Bangor’s three treatment clinics and 1,500 methadone slots are the only ones available in that part of the state.
“Anyone with a methadone treatment requirement is using Bangor as a resource,” he said. “One of things we’ve discussed is the lack of state funding for the treatment process because many of the people involved in treatment are not able to handle the cost of methadone or suboxone treatment. That’s becoming an issue across the state, particularly as we see a greater influx of illegal drugs coming in.”
Durgin said the state needs a balanced approach to the heroin problem.
Brennan, the Portland mayor, said, “I don’t get the sense at this point that the governor or the commissioner of DHHS have a coordinated strategy for simultaneously addressing enforcement and substance abuse treatment issues.”
Steve Mistler can be contacted at 620-7016 or at:
smistler@pressherald.com
Twitter: @stevemistler
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